Healthcare Provider Details

I. General information

NPI: 1174693808
Provider Name (Legal Business Name): STEWART PSYCHOLOGICAL SERVICES, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7920 KIRKLAND CT
PORTAGE MI
49024-4974
US

IV. Provider business mailing address

8469 E STURTEVANT AVE
RICHLAND MI
49083-8543
US

V. Phone/Fax

Practice location:
  • Phone: 269-345-0669
  • Fax: 269-345-5354
Mailing address:
  • Phone: 269-806-9571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. EMILY STEWART STEVENS
Title or Position: OWNER/MEMBER
Credential: PSYD, MA
Phone: 269-806-9571